Increased 18F-FDG Uptake in IgG4-related Coronary Periarterial Pseudotumor.

A 71-year-old man had been diagnosed with Immunoglobulin G4 (IgG4)-related coronary periarteritis at 66 years of age. His left circumferential artery was surrounded by an inflammatory pseudotumor. He underwent coronary bypass surgery two months later, followed by percutaneous coronary intervention to the left circumferential artery. The patient has since been followed-up periodically by computed tomography and medication without corticosteroid treatment on an outpatient basis (Picture 1). At 5.1 years after the initial admission, 18F-fluorodeoxyglucose (FDG) positron emission tomography after a 12.5-h fast showed increased FDG uptake in the periarterial pseudotumor (Picture 2). Thus far, only a few reports described increased FDG uptake in the periarterial region of histopathologically-proven IgG4-related coronary periarteritis (2). These findings of five years' follow-up in our patient suggest that enhanced FDG uptake, and thus persistent immune-inflammation, may not aggravate coronary artery remodeling, such as aneurysmal formation, without steroid treatment.

Picture 1.

Picture 2.

The authors state that they have no Conflict of Interest (COI).